As of Tuesday, four Kentucky children remain hospitalized after suffering E. coli O157:H7 infections. The cluster of cases is being investigated by the Lincoln Trail District Health Department based in Elizabethtown and the Kentucky State Department of Health.

According to news reports, the first illness was reported in mid-August. Health Department Public Information Officer Wendy Keown says investigators are trying to determine if there is a common cause.  There is a possibility of a sixth case as well.

“We thoroughly investigate activities such as recent travel, exposure to animals, food histories. You know, have they been swimming anywhere? And try to find any commonality between those to determine a source.  As of right now, there has not been a confirmed source of infection identified,” said Keown.

The children have developed hemolytic uremic syndrome (HUS), a rare and potentially fatal blood disorder.  The children range in age from 18 months to six years.

Keown says they are suffering kidney related problems. She says three of the children are from Hardin County and one each from Oldham and Boone Counties.

It’s possible they are not tied together, but Keown says that’s not likely.

According to the Kentucky Health Department, five Kentucky children have been diagnosed with Hemolytic-uremic syndrome, or HUS, likely caused by E. coli O157:H7.

The Department for Public Health said there are three cases in Hardin County and one each in Nelson and Oldham Counties. All the children are currently hospitalized.

Kosair Children’s Hospital released this statement at noon on September 13:

Several children from several different counties in Kentucky are being treated for hemolytic uremic syndrome at Kosair Children’s Hospital. In children, this syndrome is most often caused by E. coli O157:H7 infection. We have notified the state health department, which has begun an investigation.

Whole Foods Market locations, South Weymouth, Mass. and Newton, Mass., are recalling 368 pounds of ground beef products that may be contaminated with E. coli O157:H7, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced today.

125 lbs. of the following ground beef products produced on June 8, 2014 at the Newton, Mass. location are subject to recall:

  • “BEEF GROUND SIRLOIN 93% LEAN 7% FAT” with SKU 90013
  • “BEEF GROUND SIRLOIN 93% LEAN 7% FAT FAMILY PACK” with SKU 90247
  • “BEEF SIRLOIN Patty  93% LEAN / 7% Fat” with SKU 90088
  • “BEEF GROUND 93% LEAN / 7% FAT” with SKU 90035
  • “BEEF GROUND SIRLOIN 93% LEAN 7% FAT patty FAMILY PACK” with SKU 52179
  • “BEEF GROUND 85% LEAN 15% FAT” with SKU 90004
  • “BEEF GROUND 85% LEAN 15% FAT FAMILY PACK” with SKU 90037
  • “BEEF GROUND PATTY 90% LEAN GRASS FED” with SKU 96363
  • “BEEF GROUND PATTY 90% LEAN GRASS FED, Value Pack” with SKU 52162
  • “BEEF GROUND 90% LEAN GRASS FED” with SKU 95997
  • “BEEF GROUND 90% LEAN GRASS FED, Value pack” with SKU 52190
  • “BEEF GROUND 85 15 GRASS FED” with SKU 95195
  • “BEEF GROUND 85 15 PATTIES GRASS FED” with SKU 95196
  • “BEEF BURGER GRASS FED GOURMET FEATURED” with SKU 52871

170 lbs. of the following ground beef products produced on June 10, 2014 at the Newton, Mass. location are subject to recall:

  • “BEEF GROUND SIRLOIN 93% LEAN 7% FAT” with SKU 90013
  • “BEEF GROUND SIRLOIN 93% LEAN 7% FAT FAMILY PACK” with SKU 90247
  • “BEEF SIRLOIN Patty  93% LEAN / 7% Fat” with SKU 90088
  • “BEEF GROUND 93% LEAN / 7% FAT” with SKU 90035
  • “BEEF GROUND SIRLOIN 93% LEAN 7% FAT patty FAMILY PACK” with SKU 52179
  • “BEEF GROUND SIRLOIN 93/7 PATTIES NE” with SKU 90199
  • “BEEF GROUNDSIRLOIN 93/7 NE” with SKU 95051
  • “BEEF GROUND 85% LEAN 15% FAT” with SKU 90004
  • “BEEF GROUND 85% LEAN 15% FAT FAMILY PACK” with SKU 90037
  • “BEEF GROUND PATTY 90% LEAN GRASS FED” with SKU 96363
  • “BEEF GROUND PATTY 90% LEAN GRASS FED, Value Pack” with SKU 52162
  • “BEEF GROUND 90% LEAN GRASS FED” with SKU 95997
  • “BEEF GROUND 90% LEAN GRASS FED, Value pack” with SKU 52190
  • “BEEF GROUND 85 15 GRASS FED” with SKU 95195
  • “BEEF GROUND 85 15 PATTIES GRASS FED” with SKU 95196
  • “BEEF BURGER GRASS FED GOURMET FEATURED” with SKU 52871

73 lbs. of the following ground beef products produced on June 21, 2014 at the South Weymouth, Mass. location are subject to recall:

  • “BEEF GROUND PATTY 90% LEAN GRASS FED” with SKU 96363
  • “BEEF GROUND PATTY 90% LEAN GRASS FED, Value Pack” with SKU 52162
  • “BEEF GROUND 90% LEAN GRASS FED” with SKU 95997
  • “BEEF GROUND 90% LEAN GRASS FED, Value pack” with SKU 52190
  • “BEEF GROUND 85 15 GRASS FED” with SKU 95195
  • “BEEF GROUND 85 15 PATTIES GRASS FED” with SKU 95196
  • “BEEF BURGER GRASS FED GOURMET FEATURED” with SKU 52871
  • “BEEF GROUND SIRLOIN 93% Lean 7% fat”  with SKU 90013
  • “BEEF GROUND SIRLOIN 93% LEAN 7% FAT FAMILY PACK” with SKU 90247
  • “BEEF SIRLOIN Patty 93% LEAN / 7% Fat” with SKU 90088
  • “BEEF GROUND 93% LEAN / 7% FAT” with SKU 90035
  • “BEEF GROUND SIRLOIN 93% LEAN 7% FAT patty  FAMILY PACK” with SKU 52179
  • “BEEF GROUND SIRLOIN 93/7 PATTIES NE” with SKU 90199
  • “BEEF GROUND SIRLOIN 93/7 NE” with SKU 95051

FSIS was notified of an investigation of E. coli O157:H7 illnesses on June 25, 2014. Working in conjunction with the Massachusetts Department of Public Health and the Centers for Disease Control and Prevention (CDC), FSIS determined that there is a link between ground beef purchased at Whole Foods Market and this illness cluster. Based on epidemiologic investigation, 3 case-patients have been identified in Massachusetts with illness onset dates ranging from June 13, 2014 to June 25, 2014. While the onset of illnesses was in June, on August 13, 2014, additional laboratory results provided linkages between the 3 MA case-patients and ground beef purchased from Whole Foods. Traceback investigation indicated that all 3 case-patients consumed ground beef purchased from 2 Whole Foods Market prior to illness onset. FSIS is continuing to work with state and federal public health partners on this investigation to determine a common source and will provide updated information as it becomes available.

The Minnesota Department of Health has confirmed that at least 22 people on the Fond du Lac Band of Lake Superior Chippewa Reservation near Duluth have recently been sickened by foodborne illness linked to E. coli bacteria. The first illness was reported July 17.

The investigation is ongoing, but no specific cause has yet been found. The outbreak strain is believed to be E. coli O157, according to a department spokesman, which is not the one recently linked to Applebee’s restaurants in Minnesota.

The sickened reservation residents are being called and interviewed by a state epidemiologist, an environmental health supervisor and University of Minnesota graduate epidemiology students, the spokesman said.

Recent events on the reservation, including powwows, picnics, weddings, potlucks and outdoors meetings, have likely contributed to opportunities for foodborne illness. Residents were encouraged to throw away any leftover foods from these events.

Those experiencing symptoms of foodborne illness are advised to contact a health care provider or the local emergency room. More information and specific symptoms related to E. coli infection is available here.

The Minnesota Department of Health has provided the following contact numbers: toll free is 1-877-FOOD ILL (1-877-366-3455) or 1-651-201-5277 for individuals who have questions or would like to learn more about E. coli or any other foodborne illness. They advise callers to leave a message and someone will call back promptly.

 

The CDC reported on December 11, 2013, a total of 33 persons infected with the outbreak strain of E. coli O157:H7 were reported from four states.  The number of ill persons identified in each state was as follows: Arizona (1), California (28), Texas (1), and Washington (3).  32% of ill persons were hospitalized. Two ill persons developed hemolytic uremic syndrome (HUS), and no deaths were reported.

Epidemiologic and traceback investigations conducted by local, state, and federal officials indicated that consumption of two ready-to-eat salads, Field Fresh Chopped Salad with Grilled Chicken and Mexicali Salad with Chili Lime Chicken, produced by Glass Onion Catering and sold at Trader Joe’s grocery store locations, was the likely source of this outbreak of E. coli O157:H7 infections.

On June 17, 2014, the California Department of Public Health Report that concluded that:

An outbreak of E. coli O157:H7 infections occurred in October and November of 2013, affecting 33 individuals in four western states.  The outbreak disproportionately affected California residents, accounting for 85 percent of all case-patients. Two varieties of prepackaged RTE salads produced by “Company A” (Atherstone Foods – Glass Onion Catering) and sold by “GCA” (Trader Joe’s) were implicated as the source of infection.  This is supported by the statistically significant association of case-patients with consumption of one of the two implicated “GCA” salad varieties and by the regional distribution of reported cases matching the regional distribution of these two salads.  No other food items or exposures were associated with illness.  While these salads were strongly associated with the outbreak, the exact source of the contamination remains undetermined.

Today the Food and Drug Branch – Emergency Response Unit – of the California Department of Public Health produced the Environmental Investigation of an E. coli O157:H7 Outbreak in October 2013 Associated with Pre-packaged Salads. The report 28 pages long with several hundred pages of attachments, traces the consumption of the salads to the possible source of the E. coli O157:H7 contamination.

This report not only implicates the two varieties of prepackaged salads noted above, but also two others – one produced by Atherstone Foods – Glass Onion Catering – and another produced by an unnamed manufacturer in Oakland – both for sale at Walgreens.

The investigators concluded that the one common item between the two manufacturers and the four salads was romaine lettuce from a single filed in Modesto, California grown by Ratto Bros.  Five of 44 environmental samples collected in areas around the implicated farm tested positive for E. coli O157:H7, however, the “positive samples were not a genetic match to the outbreak strain” – not a match to the ill people.

Applebee’s restaurant officials have removed the chain’s popular Oriental Chicken Salad from the menu in Minnesota after at least seven diners fell ill with a rare strain of E. coli food poisoning, health officials said. The Applebee’s cases are among 13 reports of E. coli O111 infections in the state all tied to the same genetic strain of the bug — one that has not previously been seen in the U.S. In addition, two more cases have been reported in two other unidentified states, according to the Centers for Disease Control and Prevention. The six remaining cases in Minnesota appear to have no connection with Applebee’s, health officials said. Four of those sickened were hospitalized. Restaurant officials are cooperating fully with officials and pulled the salad and other ingredients included from the menu as a precaution. E. coli O111 is in the same family as the E. coli O157 typically tied to ground beef outbreaks. The infections are particularly dangerous to children and the elderly and can cause life-threatening complications. Anyone who visited a Minneapolis Applebee’s after June 20 and shows signs of diarrheal illness should contact a doctor.

Published by the Public Health Protection Unit of NHS Greater Glasgow and Clyde, the report said that 19 of the cases ate beef burgers at the Big Grill  at SSE Hydro between 17 and 19 January, 2013. The remaining three individuals, all female, were “household contacts of these primary cases.”

The report said that the investigation uncovered evidence “strongly suggesting the possibility of processing errors leading to undercooking as well as the potential for cross contamination in the preparation and serving of the beef burger products.

The report also found that in the preparation of the burgers the searing of the meat was uneven, with some appearing to be well-seared while others “were barely seared with pink raw meat visible on the surface of the burger.”

Inspectors observed inadequacy of temperature monitoring records and weaknesses in temperature monitoring of food to test how cooked items were by staff.

It was also discovered there was “an inappropriate cleaning and disinfection regime, and an absence of documented evidence of a hazard analysis” at the venue.

As of June 27, 2014, a total of 18 persons infected with the outbreak strain of Shiga toxin-producing Escherichia coli O121 (STEC O121) have been reported from five states.

The number of ill persons identified in each state is as follows: Idaho (3), Michigan (1), Montana (2), Utah (1), and Washington (11).

44% of ill persons have been hospitalized. No ill persons have developed hemolytic uremic syndrome (HUS), and no deaths have been reported.

Epidemiology and traceback investigations conducted by local, state, and federal officials indicated that contaminated raw clover sprouts produced by Evergreen Fresh Sprouts, LLC of Idaho are the likely source of this outbreak.

The FDA conducted an inspection of Evergreen Fresh Sprouts’ facility on May 22-23, 2014; May 27-30, 2014; and June 6, 2014. During the inspection, FDA investigators observed a number of unsanitary conditions, including condensate and irrigation water dripping from rusty valves; a rusty and corroded mung bean room watering system; tennis rackets that had scratches, chips, and frayed plastic” used to scoop mung bean sprouts; a pitchfork with corroded metal being used to transfer mung bean sprouts; and a squeegee with visible corroded metal and non-treated wood being used to agitate mung bean sprouts inside a soak vat.

A total of 12 persons infected with the outbreak strain of E. coli O157:H7 were reported from 4 states. The number of ill persons reported from each state was as follows: Massachusetts (1), Michigan (5), Missouri (1), and Ohio (5).  58% of ill persons were hospitalized. No ill persons developed hemolytic uremic syndrome (HUS), and no deaths were reported.

Epidemiologic and traceback investigations conducted by local, state, and federal officials indicated that contaminated ground beef produced by Wolverine Packing Company was the likely source of this outbreak of STEC O157:H7 infections.

On May 19, 2014, Wolverine Packing Company recalled approximately 1.8 million pounds of ground beef products that may be contaminated with STEC O157:H7.  The products subject to recall bear the establishment number “EST. 2574B.”  The recalled ground beef was shipped to distributors for retail and restaurant use nationwide. There was no distribution of the products to the U.S. Department of Defense, the National School Lunch Program, or catalog/internet sales.  The recalled ground beef was also distributed to a limited number of retail establishments for consumer purchase.  Read the full list of products that were recalled.

Epidemiology and traceback investigations conducted by local, state, and federal officials indicated that contaminated raw clover sprouts produced by Evergreen Fresh Sprouts, LLC of Idaho are the likely source of this outbreak.  In interviews, 12 (86%) of 14 ill persons reported eating raw clover sprouts in the week before becoming ill.

As of June 9, 2014, a total of 17 persons infected with the outbreak strain of Shiga toxin-producing Escherichia coli O121 (STEC O121) have been reported from five states.  The number of ill persons identified in each state is as follows:  Idaho (3), Michigan (1), Montana (2), Utah (1), and Washington (10).  47% of ill persons have been hospitalized. No ill persons have developed hemolytic uremic syndrome (HUS), and no deaths have been reported.

The FDA conducted an inspection of Evergreen Fresh Sprouts’ facility on May 22-23, 2014; May 27-30, 2014; and June 6, 2014. During the inspection, FDA investigators observed a number of unsanitary conditions, including condensate and irrigation water dripping from rusty valves; a rusty and corroded mung bean room watering system; tennis rackets that had scratches, chips, and frayed plastic” used to scoop mung bean sprouts; a pitchfork with corroded metal being used to transfer mung bean sprouts; and a squeegee with visible corroded metal and non-treated wood being used to agitate mung bean sprouts inside a soak vat.

Raw clover sprouts have not been recalled from Evergreen Fresh Sprouts. Because contaminated sprouts may still be available on the market, CDC recommends that consumers do not eat any raw clover sprouts produced by Evergreen Fresh Sprouts.  The Washington State Department of Health and the Idaho Department of Health and Welfare are also advising people not to eat raw clover sprouts produced by Evergreen Fresh Sprouts.